神经移植在面神经功能重建中的应用  

Application of nerve transplantation in facial nerve functional reconstruction

作　　者：沈艺漫 朱婉春 陈正 蔡小敏 王好鹏 王柏淼 李世亭[1] SHEN Yiman;ZHU Wanchun;CHEN Zheng;CAI Xiaomin;WANG Haopeng;WANG Baimiao;LI Shiting(Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200082,China)

机构地区：[1]上海交通大学医学院附属新华医院,上海200082

出　　处：《中国实用神经疾病杂志》2023年第4期509-514,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：面神经损伤引起的面部功能障碍可由多种原因造成,其不仅导致患者生活质量下降,而且进一步影响正常社交活动,因此面神经修复的主要目的在于提高患者面部对称性以及恢复社交能力,目前治疗方式包括药物治疗、康复治疗以及各类外科干预等。轻症初期面瘫患者往往会先选择保守治疗,对于保守无效或中重度面瘫的情况,神经移植是有效且可靠的治疗手段,主要术式包括咬肌神经-面神经移植(MFNN)、舌下神经-面神经移植(HFA)、跨面神经移植及其改良、联合的术式,迄今仍无统一的治疗指南。本文就面神经功能重建中不同神经移植术式进行简单地描述,重点对比其优缺点、适应证以及术后疗效,为日后临床术式选择提供一些参考。Facial dysfunction resulted from facial nerve injury can be caused by various reasons.It not only leads to the deterioration of patients' quality of life,but also further affects their normal social activities.Hence,the core aim of facial nerve rehabilitation is to improve the facial symmetry and restore their social interaction.Currently,medical treatments such as drugs,rehabilitation training,and surgical operations are the most common clinical interventions.Conservative treatments in patients with mild facial paralysis are preferred.For patients with moderate-to-severe facial paralysis or who had failed in conservative treatments,nerve transplantation is one of the most effective and reliable methods,including masseteric-facial nerve neurorrhaphy(MFNN),hypoglossalfacial nerve anastomosis(HFA),and reform or combination surgery based on them.However,to date,the standard treatment guideline remains not perfection and unity yet.Therefore,in order to provide some instrumental references in selecting the optimal surgical methods in the future,in this article,nerve transplantation methods are briefly described in facial nerve reconstruction,focusing on the comparison of advantages and disadvantages,indications and postoperative efficacy between different procedures.

关 键 词：面神经损伤 面瘫 神经移植 咬肌神经 舌下神经 颈神经 跨面神经移植 

分 类 号：R745.12[医药卫生—神经病学与精神病学]